Expanding COVID-19 vaccine eligibility to younger kids could combat rising cases if enough parents say yes

More than 23,000 children in Pennsylvania contracted the coronavirus in the first three weeks of September, part of a national increase over the last month that has closed schools, worried parents, and heightened urgency for the authorization of vaccination for younger children.

The expansion of vaccine eligibility to about 28 million U.S. kids appears closer than ever—expected within weeks, possibly before October’s end—and it could improve the pandemic outlook for everyone.

Children 5 to 14 make up about 11.5% of the commonwealth’s population. The CDC, which slightly overcounts the state’s vaccination rate, says about 72% of Pennsylvania residents have received at least one vaccine dose; if half of children 5 to 14 got vaccinated, that alone would push the overall rate to 78%. If three-quarters did, the rate would go up to 80%.

Vaccinations in kids could boost population immunity, quash cases in schools, and help fend off a severe fall or winter surge. Most important, pediatricians said, the vaccine offers long-awaited protection for children from the real danger of catching the virus.

The authorization “will help make [children’s] lives a bit more normal … [and] will certainly be also a step in controlling the pandemic,” said Annette Reboli, dean of Cooper Medical School of Rowan University and a doctor specializing in infectious disease. “The more people in general that can get vaccinated, the closer we become to ending the pandemic.”

The head of Pfizer said Monday that the company would apply for FDA approval for its vaccine for children 5 to 11 within days, and CDC director Rochelle Walensky said she hoped it would be authorized “in the order of weeks,” pledging urgency from the FDA and CDC in reviewing the data.

But it all depends on how many parents decide to immunize their children—something that remains a question mark, despite pediatricians’ firm endorsements of the vaccine.

“Every step in the direction of a fully vaccinated population is a step in the right direction toward getting past this thing,” said Robert Noll, chair of the pediatrics department at Crozer-Chester Medical Center. “We’ve got the opportunity to vaccinate another huge chunk of the population. Even though some will say no … every step forward is good.”

There are reasons for uncertainty, however: Immunization rates among those 12 to 17 have remained lower than any other age group in Pennsylvania. And nationwide about a quarter of parents with kids 5 to 11 polled by the Kaiser Family Foundation last month said they would vaccinate their children as soon as they could, while 40% said they would “wait and see.”

Meanwhile, new pediatric cases and hospitalizations have been going up—Pennsylvania’s relatively low number of hospitalized kids nearly doubled over the last two months, according to data from Children’s Hospital of Philadelphia’s PolicyLab, while states with lower vaccination rates have fared far worse.

The number of new cases has also been rising: Pennsylvania recorded 20,500 new cases in kids 5 to 18 during the first three weeks of September, plus 3,000 in day-care-age children under 5.

More than 1.1 million new cases were recorded among children between Aug. 20 and Sept. 23, and one week in September saw the third-highest number of child cases in a week since the pandemic began, according to the American Academy of Pediatrics, which tracks pediatric cases nationally. And more than 930,000 students have been affected by COVID-19 school closures, the CDC said in a Friday report, a number that includes greater spikes in pediatric cases in places without school mask requirements.

Children, who make up 22% of the population, accounted for nearly 27% of reported weekly cases on Friday—compared to about 15% for the whole pandemic.

“I just hope those kinds of statistics will also inspire people to say, ‘This is no joke, let’s get it done for the kids,'” said Noll, Crozer-Chester’s pediatrics chair. “This is not just the benevolence of trying to protect the world from the pandemic. These kids could actually get really sick.”

“The wild card,” said Reboli, Cooper’s dean, is how many parents will bring their children for shots. Pediatricians are seeing families fall into various camps: Yes, wait-and-see, no, and various shades in between.

For instance, Noll said he’s seen enthusiasm about the vaccine from parents and kids in and around Chester. But in the Hunting Park section of Philadelphia, Natalie Mathurin, a pediatrician at Greater Philadelphia Health Action Inc., said more than half of the parents she sees don’t plan to get their 5-to-11-year-old children vaccinated, at least not immediately, because they don’t think it’s necessary.

Adding children to the eligible pool isn’t the same as adding a new swath of adults. It comes with a different set of considerations and worries for parents, including many who are vaccinated themselves and say they’re unsure about immunizing their children.

Sometimes, that stems from the widespread belief that children aren’t as affected by the virus. But doctors said that frustrated them: While children remain much less likely than adults to have severe cases, parents shouldn’t bet against COVID-19, they said.

“The risk from COVID remains much higher than any risk from getting a vaccine,” Reboli said. “Right now, the risk of getting COVID is very real for these children.”

Children often spread the virus, too, sometimes passing it to others without getting symptoms themselves. So vaccinating them will help protect adults, as well.

“That asymptomatic child, that’s just a domino effect. They go to school … teachers go home and take that home to their families, other kids take that to their families,” Mathurin said. “It can have a very far-reaching effect.”

And that means, she said, “Even if it’s a small amount, initially, of families who say yes to the vaccine, it can have big impacts.”

Mathurin said she wants to get her 8-year-old son vaccinated so he can return to being the active, social child he was pre-pandemic. And, she added, so his school year can be as normal as possible.

For Rachel Taylor Brown of Rydal, keeping her daughter Sydnee in school is among the top reasons she wants to get the 7-year-old immunized. She has been “obsessively waiting” for the day she can sign Sydnee up for shots.

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